The present invention generally relates to an improvement in the selection and presentation of medical imaging studies. More specifically, the present invention relates to key image note matching by image hanging protocols.
Picture archiving and communication systems (“PACS”) connect to medical diagnostic imaging devices and employ an acquisition gateway (between the acquisition device and the PACS), storage and archiving units, display workstations, databases, and sophisticated data processors. These components are integrated together by a communication network and data management system. A PACS has, in general, the overall goals of streamlining health-care operations, facilitating distributed remote examination and diagnosis, and improving patient care.
A typical application of a PACS system is to provide one or more medical images for examination by a medical professional. For example, a PACS system can provide a series of x-ray images to a display workstation where the images are displayed for a radiologist to perform a diagnostic examination. Based on the presentation of these images, the radiologist can provide a diagnosis. For example, the radiologist can diagnose a tumor or lesion in x-ray images of a patient's lungs.
A series or sequence of a plurality of medical images is an imaging study. In general, an imaging study that is the most recent imaging study of a patient or is the imaging study currently being examined by a radiologist will be referred to as a current imaging study.
In order to properly diagnose a current imaging study, a radiologist must examine one or more previously acquired images of the same patient and compare these images to images of a current study. An imaging study that includes two or more previously acquired images is a historical imaging study. Furthermore, a historical imaging study whose images are relevant for comparing with the images of a current imaging study is a comparison imaging study. For example, images that are associated with or display the same anatomy are relevant for comparison purposes.
The images of an imaging study are displayed in a particular spatial layout and/or temporal sequence. In other words, the images may be displayed in certain positions on a display device relative to each other (a spatial layout, for example). The images may also be displayed in a certain ordered sequence by displaying image A first, followed by image B, followed by image C, and so on (a temporal sequence, for example). The spatial and/or temporal presentation of images is directed by a set of display rules. A display rule may include a set of instructions stored on a computer-readable media that direct the presentation of images on a display workstation. A set of display rules is known as an image hanging protocol. In general, an image hanging protocol is a series of display rules that dictate the spatial and/or temporal layout and presentation of a plurality of images.
Image hanging protocols are used in current PACS systems to present images of a diagnostic study for display. Image hanging protocols allow a user to specify studies for population into image layouts or regions, as well as the appearance of the layouts or regions. Furthermore, the user may specify which image hanging protocols are used to display which studies. The idea is to automate the presentation of images in the way most desired by the user.
Integrating the Healthcare Enterprise (“IHE”) introduced the concept of a Key Image Note (“KIN”). A KIN is a note that marks one or more images in a study as significant, and specifies why the images are significant. More particularly, the KIN specifies image significance through KIN Title/Subtitles, which are defined by the DICOM standard. For example, to mark images to be shown to patient, one could create a KIN whose Title is “For Patient” and which references those images. As another example, to mark images as having quality artifact issues, one could create a KIN with a Title of “Quality Issue”, a Subtitle of “Image artifact(s)”, and which references those images.
A KIN may include a title, and optionally, a subtitle, a creation date, a creation time, a creator, and/or a creator type. Some users may be interested in some KIN categories more so that other KIN categories. For example, a surgeon may be interested in “For Surgery” KIN images. As another example, an instructor at a teaching institution may be interested in “For Teaching” and “For Research” KIN images. As another example, a primary care physician may be interested in “For Referring Provider” and “Best In Set” KIN images.
Furthermore, the KIN Titles/Subtitles are fully extensible by DICOM. Therefore, a user could create custom KIN categories or types, and utilize the custom KIN category or type to zero in on images of a specific interest. For example, a user may be interested in KIN images created by a radiologist or KIN images created by a technologist. As another example, a user may be interested in the most recent KIN images.
Current PACS systems implement image hanging protocols and KINs. However, finding and displaying relevant key images (e.g., KIN images) upon displaying the images of a study is a manual process and requires a user to perform several steps. For example, a user first selects a default image hanging protocol. The default image hanging protocol loads all images in a study. Next, the user selects a KIN. The selected KIN images are then loaded into an image layout. These steps are cumbersome, time-consuming, and inefficient for the user, especially in studies involving high volumes of images and KINs.
Thus, there is a need for an efficient way for a user to view images of interest upon the display of a study. This is especially true for environments where time is critical. For example, physicians in the Emergency Room or surgeons in the Operating Room need to be able to view “For Physician” and “For Surgery” KIN images as efficiently as possible. Even for a radiologist or other user, elimination of time lost due to extra steps in a workflow can greatly contribute to the efficiency and the quality of healthcare.